- Cecilie Blimark1,*,
- Erik Holmberg2,
- Ulf-Henrik Mellqvist1,
- Ola Landgren3,
- Magnus Björkholm4,
- Malin L. Hultkrantz4,
- Christian Kjellander5,
- Ingemar Turesson6 and
- Sigurdur Y. Kristinsson7
- 1 Sahlgrenska University Hospital, Sweden;
- 2 Department of Oncology, Institute of clinical sciences, Sahlgrenska Academy, Sweden;
- 3 Myeloma Service, Division of Hematology Oncology, Memorial Sloan-Kettering Cancer center, New York;
- 4 Department of Medicine, Division of Hematology, Karolinska University Hospital and Karolinska Insti;
- 5 Department of Medicine, Karolinska Institutet;
- 6 Malmö University Hospital, Sweden;
- 7 Karolinska University Hospital, Solna and Karolinska Institutet, Sweden
- ↵* Corresponding author; email:
Infections are a major cause of morbidity and mortality in patients with multiple myeloma. To estimate the risk of bacterial and viral infections in multiple myeloma patients, we used population-based data from Sweden to identify all multiple myeloma patients (n=9 253) diagnosed from 1988 to 2004 with follow-up to 2007 and 34 931 matched controls. Cox proportional hazard models were used to estimate the risk of infections. Overall, multiple myeloma patients had a 7-fold (hazard ratio =7.1; 95% confidence interval = 6.8-7.4) risk of developing any infection compared to matched controls. The increased risk of developing a bacterial infection was 7-fold (7.1; 6.8-7.4), and for viral infections 10-fold (10.0; 8.9-11.4). Multiple myeloma patients diagnosed in the more recent calendar periods had significantly higher risk of infections compared to controls (p<0.001). At one year of follow-up, infection was the underlying cause in 22% of deaths in multiple myeloma patients. Mortality due to infections remained constant during the study period. Our findings confirm that infections represent a major threat to multiple myeloma patients. The effect on infectious complications due to novel drugs introduced in the treatment of multiple myeloma needs to be established and trials on prophylactic measures are needed.
- Received March 24, 2014.
- Accepted October 21, 2014.
- Copyright © 2014, Ferrata Storti Foundation